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  • Question 1 - What is the mechanism of action of penicillin antibiotics: ...

    Correct

    • What is the mechanism of action of penicillin antibiotics:

      Your Answer: Inhibition of bacterial cell wall synthesis

      Explanation:

      Penicillins and the other ß-lactam antibiotics are bactericidal. They produce their antimicrobial action by preventing cross-linkage between the linear peptidoglycan polymer chains that make up the bacterial cell wall. They, therefore, inhibit cell wall synthesis.
      The integrity of the ß-lactam ring is essential for antimicrobial activity. Many bacteria (including most Staphylococci) are resistant to benzylpenicillin and phenoxymethylpenicillin because they produce enzymes (penicillinases, ß-lactamases) that open the ß-lactam ring.

    • This question is part of the following fields:

      • Infections
      • Pharmacology
      10
      Seconds

  • Question 2 - Dysuria and urinary frequency are symptoms of a 29-year-old woman. A urine dipstick...

    Incorrect

    • Dysuria and urinary frequency are symptoms of a 29-year-old woman. A urine dipstick is used to detect the presence of blood, protein, leucocytes, and nitrites in the urine. You diagnose a urinary tract infection and give antibiotics to the patient.

      In the United Kingdom, which of the following antibiotics has the highest percentage of E.coli resistance?

      Your Answer: Nitrofurantoin

      Correct Answer: Trimethoprim

      Explanation:

      In the United Kingdom, antibiotic resistance is becoming a significant factor in the treatment of urinary tract infections and pyelonephritis. E. coli (the main causative organism of both urinary tract infections and acute pyelonephritis) resistance to the following antibiotics in laboratory-processed urine specimens is:
      30.3 percent trimethoprim (varies by area from 27.1 to 33.4 percent )
      19.8 percent co-amoxiclav (varies by area from 10.8 to 30.7 percent )
      Ciprofloxacin (Cipro): 10.6% (varies by area from 7.8 to 13.7 percent )
      Cefalexin has a concentration of 9.9%. (varies by area from 8.1 to 11.4 percent )

    • This question is part of the following fields:

      • Infections
      • Pharmacology
      18.4
      Seconds

  • Question 3 - Which of the following infections is vancomycin most likely prescribed for? ...

    Correct

    • Which of the following infections is vancomycin most likely prescribed for?

      Your Answer: Clostridium difficile colitis

      Explanation:

      125 mg PO q6hr for 10 days is indicated for treatment of Clostridium difficile (C. difficile)-associated diarrhoea

    • This question is part of the following fields:

      • Infections
      • Pharmacology
      15.4
      Seconds

  • Question 4 - A 46-year-old male who is suffering from a chest infection. You decide to start giving...

    Incorrect

    • A 46-year-old male who is suffering from a chest infection. You decide to start giving the patient antibiotics, however he is allergic to penicillin. You consult with one of your co-workers about the best choice of antibiotic to give.

      From the following choices, which is considered an example of bacteriostatic antibiotic?

      Your Answer: Ciprofloxacin

      Correct Answer: Trimethoprim

      Explanation:

      Antibiotics that are bactericidal kill bacteria, while antibiotics that are bacteriostatic limit their growth or reproduction. The antibiotics grouped into these two classes are summarized in the table below:

      Bactericidal antibiotics
      Bacteriostatic antibiotics

      Vancomycin
      Metronidazole
      Fluoroquinolone, such as ciprofloxacin
      Penicillins, such as benzylpenicillin
      Cephalosporin, such as ceftriaxone
      Co-trimoxazole
      Tetracyclines, such as doxycycline
      Macrolides, such as erythromycin
      Sulphonamides, such as sulfamethoxazole
      Clindamycin
      Trimethoprim
      Chloramphenicol

    • This question is part of the following fields:

      • Infections
      • Pharmacology
      19.1
      Seconds

  • Question 5 - Cefotaxime (or ceftriaxone) is used first line for which of the following infections:...

    Correct

    • Cefotaxime (or ceftriaxone) is used first line for which of the following infections:

      Your Answer: Blind treatment of suspected bacterial meningitis

      Explanation:

      Cefotaxime (or ceftriaxone) are indicated first line in:
      – Blind treatment of meningitis in patients > 3 months (with amoxicillin if patient > 50 years)
      – Meningitis caused by meningococci
      – Meningitis caused by pneumococci
      – Meningitis caused by H. influenzae
      – Severe or invasive salmonellosis
      – Typhoid fever
      – Gonorrhoea
      – Gonococcal arthritis
      – Haemophilus influenzae epiglottitis

    • This question is part of the following fields:

      • Infections
      • Pharmacology
      17
      Seconds

  • Question 6 - An 11-year-old presented to a GP with a history of headache, neck stiffness...

    Correct

    • An 11-year-old presented to a GP with a history of headache, neck stiffness and photophobia. On examination, HR is 122, BP is 87/42, RR is 28, SaO 2 is 95%, temperature is 39.4 o C. There is a recent petechial rash on legs and arms. The GP administered a dose of antibiotics in the prehospital setting before transferring to the Emergency Department. Which of these would the GP have administered?

      Your Answer: IM benzylpenicillin 1.2 g

      Explanation:

      General Practitioners are advised to give a single injection of benzylpenicillin by intravenous or intramuscular injection before transferring the patient urgently to the ED when bacterial meningitis is suspected.

      The recommended doses are:
      Infants under 1 year: 300 mg
      Children ages 1 to 9 years: 600 mg
      Children aged 10 years and over: 1.2g
      Adults: 1.2g

    • This question is part of the following fields:

      • Infections
      • Pharmacology
      18.2
      Seconds

  • Question 7 - Flucloxacillin is used first line for all of the following infections EXCEPT for:...

    Incorrect

    • Flucloxacillin is used first line for all of the following infections EXCEPT for:

      Your Answer: Osteomyelitis

      Correct Answer: Otitis media

      Explanation:

      Flucloxacillin is used first line for treatment of widespread impetigo infection, cellulitis, mastitis, osteomyelitis, septic arthritis, severe erysipelas, severe/spreading otitis externa and infective endocarditis caused by staphylococci. Amoxicillin is first line for acute otitis media.

    • This question is part of the following fields:

      • Infections
      • Pharmacology
      11.3
      Seconds

  • Question 8 - A 23 year old student presents to ED with a widespread maculopapular rash....

    Correct

    • A 23 year old student presents to ED with a widespread maculopapular rash. She recently had a sore throat and was started on a course of antibiotics. The most likely antibiotic that she was prescribed is:

      Your Answer: Amoxicillin

      Explanation:

      Maculopapular rashes are commonly seen with ampicillin and amoxicillin. However they are not usually related to true penicillin allergy. Very often, they occur in patients with glandular fever and so, broad-spectrum penicillins should not be used blindly, for management and treatment of a sore throat. There is also an increased risk of rash in patients with acute or chronic lymphocytic leukaemia or in cytomegalovirus infection.

    • This question is part of the following fields:

      • Infections
      • Pharmacology
      17.9
      Seconds

  • Question 9 - Which of the following antibiotics may be used for malaria prophylaxis: ...

    Correct

    • Which of the following antibiotics may be used for malaria prophylaxis:

      Your Answer: Doxycycline

      Explanation:

      Doxycycline may be used for malaria prophylaxis and as an adjunct to quinine in the treatment of Plasmodium falciparum malaria.

    • This question is part of the following fields:

      • Infections
      • Pharmacology
      7.5
      Seconds

  • Question 10 - A 60-year-old male presents to the genitourinary clinic with dysuria and urinary frequency...

    Incorrect

    • A 60-year-old male presents to the genitourinary clinic with dysuria and urinary frequency complaints. He has a past medical history of benign prostate enlargement, for which he has been taking tamsulosin. There is blood, protein, leucocytes, and nitrites on a urine dipstick. Fresh blood tests were sent, and his estimated GFR is calculated to be >60 ml/minute. A urinary tract infection (UTI) diagnosis is made, and he is prescribed antibiotics. Out of the following, which antibiotic is most appropriate to be prescribed to this patient?

      Your Answer: Cefalexin

      Correct Answer: Ciprofloxacin

      Explanation:

      URINARY TRACT INFECTIONS IN ADULT MEN
      Symptomatic urinary tract infections are much less common in men than in women, and all UTIs
      in men are considered complicated UTIs. Men with UTIs should be evaluated for predisposing or
      causative factors.

      Uncomplicated cystitis

      • Fosfomycin, oral, 3 g as a single dose.

      If fosfomycin is unavailable:

      • Nitrofurantoin, oral, 100 mg 6 hourly for 5 days.

      Do not use nitrofurantoin or fosfomycin if there is any suspicion of early pyelonephritis as they do
      not achieve adequate renal tissue levels.
      If there are any factors precluding the use of the above agents, then a beta-lactam should be used.
      Options include:
      Cefixime 200 mg PO 12 hourly for 7 days
      OR
      Cefpodoxime 100 mg PO 12 hourly for 7 days

      Complicated cystitis
      Adults

      • Ciprofloxacin 500 mg PO 12 hourly
        OR
      • Levofloxacin 750 mg PO once daily

      Empiric antibiotic therapy should be changed based upon the bacteria isolated and its
      antimicrobial susceptibility.
      Treat for a total of 7–14 days

    • This question is part of the following fields:

      • Infections
      • Pharmacology
      18
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Infections (6/10) 60%
Pharmacology (6/10) 60%
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